CH EPR FHIR (R4), published by eHealth Suisse. This guide is not an authorized publication; it is the continuous build for version 4.0.0-ci-build built by the FHIR (HL7® FHIR® Standard) CI Build. This version is based on the current content of https://github.com/ehealthsuisse/ch-epr-fhir/ and changes regularly. See the Directory of published versions

Mobile Access to Health Documents (MHD) with XDS on FHIR

This section specifies Swiss national extensions to the Mobile Access to Health Documents (MHD) with XDS on FHIR Profile, which is published as an IHE ITI Trial Implementation profile.

The national extensions adds an additional transaction to≈from the Document Source to the Document Recipient.

Scope

An EPR App can query, retrieve or publish data to an EPR community using the transaction of the MHD profile. An EPR App can Update Document Metadata for a published document with this national extension.

Use Cases

In addition to the Document Sharing Use Case for MHD the national extension defines the following Use Cases:

Document Metadata update from a Health Care professional with a primary system

A Healthcare professional has published a document in his own community for the patient but needs to update the metadata of the document. The healthcare professional updates the metadata (e.g. title) in the primary systems and submits the updated metadata to the community. The metadata which is allowed to be updated is defined in Annex 5.1 1.12.1.

Patient changes confidentiality code of a document

A patient wants to change the confidentiality code of one of his documents. The patient updates the confidentiality code in the portal and the portal submits the updated metadata to the community.

Actors and Transactions

This figure shows the actors directly involved in the Mobile Access to Health Documents Profile and the relevant transactions between them.

Actor options

For all actors the Comprehensive Metadata Option and the XDS on FHIR Option SHALL be supported. For all actors the Metadata as defined in Annex 3 SHALL be supported.

Required Actor Groupings

The Actors Document Recipient and Document Responder MUST be grouped according to the XDS on FHIR grouping condition see Table 33.3-1: MHD - Actors Required Grouping. This national extension enforces authentication and authorization for access control. Therefore actors of this profile must be grouped with actors of other profiles according to the following table:

Process Flow

For the process flow of this profile and its interplay with the other profiles see sequence diagrams.

Security Consideration

This national extension enforces authentication and authorization of access to the Patient Identity Manager using the IUA profile with extended access token as described in IUA.